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All peptides
GHRH analog

Tesamorelin

Also known as: Egrifta, TH9507

Tier 1 — Human RCTReviewed 2026-04-30

FDA-approved for HIV-associated lipodystrophy. Off-label use for general fat loss is meaningfully less supported.

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Overview

Tesamorelin is a 44-amino-acid synthetic analog of human growth hormone-releasing hormone (GHRH). It stimulates pulsatile endogenous GH release from the pituitary, raising IGF-1. Phase 3 trials in HIV-associated lipodystrophy demonstrated reductions in visceral adipose tissue (VAT) of roughly 15–18% and supported the FDA approval of Egrifta in 2010 for that specific indication. Off-label use for non-HIV abdominal adiposity, longevity, or body composition has substantially weaker evidence.

Mechanism

Binds the pituitary GHRH receptor, triggering endogenous pulsatile GH release. Because the GH increase is endogenous and pulsatile, the metabolic profile differs from exogenous recombinant GH — typically less impact on glucose and IGF-1 ceilings.

Evidence by indication

We classify each indication separately. The same peptide can be Tier 1 for one use and Tier 4 for another. Tiers reflect the published literature, not the strength of community framing.

HIV-associated lipodystrophy (visceral adiposity)

Tier 1high confidence

Falutz et al. and subsequent Phase 3 trials demonstrated 15–18% reduction in visceral adipose tissue at 26 weeks. FDA approved as Egrifta in 2010.

Falutz J et al. 2007Theratechnologies Inc. et al. 2019

Non-HIV abdominal adiposity

Tier 2medium confidence

Several smaller trials in non-HIV populations report reductions in VAT and triglycerides, but the bulk of the evidence is in HIV subjects. Tier 1 evidence does not propagate from the approved indication.

Stanley TL et al. 2014

NAFLD / hepatic steatosis

Tier 2medium confidence

Stanley et al. demonstrated reductions in hepatic fat fraction in HIV patients with NAFLD. Evidence in non-HIV NAFLD is more limited.

Stanley TL et al. 2014

General longevity / anti-aging

Tier 3high confidence

No human RCTs assess longevity endpoints with tesamorelin. Mechanistic claims that raising GH/IGF-1 extends healthspan rest on indirect inference, and observational data on IGF-1 and longevity are mixed (with higher IGF-1 sometimes associated with worse cancer outcomes).

No primary citations are anchored to this indication — the tier reflects the absence of usable literature, not a missing reference.

Cognitive performance

Tier 2medium confidence

A small RCT (Baker et al.) reported cognitive improvements in adults with mild cognitive impairment receiving tesamorelin. Results are interesting but unreplicated at scale.

Baker LD et al. 2012

Studied dose ranges

The ranges below come from published trial protocols where available, and from documented self-experimenter consensus where the literature does not include human dose-finding work. The notes flag which is which.

2,000–2,000 mcgonce daily · subcutaneous

FDA-approved dose for HIV lipodystrophy is 2 mg subcutaneously once daily, typically at bedtime to align with natural GH pulsatility.

Contraindications

  • Active malignancy (relative; raised IGF-1 is theoretically permissive of tumor growth)
  • Pituitary surgery, radiation, or trauma — confirm pituitary axis with provider first
  • Pregnancy and breastfeeding
  • Hypersensitivity to mannitol or other excipients
  • Severe respiratory failure or critical illness
  • Acute glucose dysregulation; tesamorelin can transiently elevate fasting glucose

Reported side effects

  • Injection site reactions (most common; redness, itching, induration)
  • Arthralgia and peripheral edema
  • Hyperglycemia and worsened insulin resistance (monitor HbA1c, fasting glucose)
  • Carpal tunnel-like symptoms with high IGF-1 elevations
  • Headache, fatigue
  • Hypersensitivity reactions (rare)

Reconstitution & storage

Egrifta SV is supplied as a lyophilized powder (1 mg or 2 mg vials) reconstituted with the supplied sterile water for injection. Swirl gently — do not shake. Use within 2 hours of reconstitution. Compounded tesamorelin sold for research must be reconstituted with bacteriostatic water and refrigerated.

Storage. Lyophilized vial: refrigerate 2–8 °C until reconstitution. Reconstituted product: use immediately. Do not freeze. Protect from light.

Open the peptide calculator → to compute exact draw volumes for your specific vial and BAC water choice.

Editorial note

FDA approval is for HIV lipodystrophy specifically. Do not promote tesamorelin as 'studied for body composition' without anchoring to that population. The longevity narrative is a particularly common over-claim — keep it Tier 3.

Citations

  1. [1]
    Effects of tesamorelin (TH9507), a growth hormone-releasing factor analog, in HIV-infected patients with excess abdominal fat
    Falutz J, Allas S, Blot K, et al. · New England Journal of Medicine · 2007 · PMID 18046018
    Tier 1 evidence for HIV lipodystrophy and the basis for FDA approval.
    View source
  2. [2]
    Effect of tesamorelin on visceral fat and liver fat in HIV-infected patients with abdominal fat accumulation
    Stanley TL, Feldpausch MN, Oh J, et al. · JAMA · 2014 · PMID 25069834
    Hepatic fat reduction in HIV patients; supports the NAFLD-adjacent claim.
    View source
  3. [3]
    Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults
    Baker LD, Barsness SM, Borson S, et al. · Archives of Neurology · 2012 · PMID 22689070
    Small-RCT support for the cognition indication.
    View source
  4. [4]
    Egrifta SV (tesamorelin) Prescribing Information
    Theratechnologies Inc. · FDA-approved label · 2019
    Approved indication, dose, and contraindications.
    View source